Physician or Surgeon

Physicians and surgeons diagnose and treat injuries or illnesses. Physicians examine patients; take medical histories; prescribe medications; and order, perform, and interpret diagnostic tests. They often counsel patients on diet, hygiene, and preventive healthcare. Surgeons operate on patients to treat injuries, such as broken bones; diseases, such as cancerous tumors; and deformities, such as cleft palates.

There are two types of physicians, with corresponding degrees: M.D. (Medical Doctor) and D.O. (Doctor of Osteopathic Medicine). Both use the same methods of treatment, including drugs and surgery, but D.O.s place additional emphasis on the body's musculoskeletal system, preventive medicine, and holistic (whole-person) patient care. D.O.s are most likely to be primary care physicians, although they can be found in all specialties.

Duties

Physicians and surgeons typically do the following:

Take a patient’s medical history

Update charts and patient information to show current findings and treatments

Order tests for nurses or other healthcare staff to perform

Review test results to identify any abnormal findings

Recommend and design a plan of treatment

Address concerns or answer questions that patients have about their health and well-being

Help patients take care of their health by discussing topics such as proper nutrition and hygiene

In addition, surgeons operate on patients to treat injuries, diseases, or deformities.

Physicians and surgeons work in one or more of several specialties. The following are examples of types of physicians and surgeons:

Anesthesiologists focus on the care of surgical patients and on pain relief. They administer the drugs (anesthetics) that reduce or eliminate the sensation of pain during an operation or another medical procedure. During surgery, they are responsible for adjusting the amount of anesthetic as needed and monitoring the patient's heart rate, body temperature, blood pressure, and breathing. They also work outside of the operating room, providing pain relief in the intensive care unit, during labor and delivery, and for those who suffer from chronic pain. Anesthesiologists work with other physicians and surgeons to decide on treatments and procedures before, during, and after surgery.

Family and general physicians assess and treat a range of conditions that occur in everyday life. These conditions include anything from sinus and respiratory infections to broken bones. Family and general physicians typically have regular, long-term patients.

General internists diagnose and provide nonsurgical treatment for a range of problems that affect internal organ systems such as the stomach, kidneys, liver, and digestive tract. Internists use a variety of diagnostic techniques to treat patients through medication or hospitalization. They work mostly with adult patients.

General pediatricians provide care for infants, children, teenagers, and young adults. They specialize in diagnosing and treating problems specific to younger people. Most pediatricians treat common illnesses, minor injuries, and infectious diseases, and administer vaccinations. Some pediatricians specialize in pediatric surgery or serious medical conditions that commonly affect younger patients, such as autoimmune disorders or chronic ailments.

Obstetricians and gynecologists (OB/GYNs) provide care related to pregnancy, childbirth, and the female reproductive system. They treat and counsel women throughout their pregnancy and deliver babies. They also diagnose and treat health issues specific to women, such as breast cancer, cervical cancer, hormonal disorders, and symptoms related to menopause.

Psychiatrists are primary mental health physicians. They diagnose and treat mental illnesses through a combination of personal counseling (psychotherapy), psychoanalysis, hospitalization, and medication. Psychotherapy involves regular discussions with patients about their problems. The psychiatrist helps them find solutions through changes in their behavioral patterns, explorations of their past experiences, or group and family therapy sessions. Psychoanalysis involves long-term psychotherapy and counseling for patients. Psychiatrists may prescribe medications to correct chemical imbalances that cause some mental illnesses.

Surgeons specialize in treating injury, disease, and deformity through operations. Using a variety of instruments, a surgeon corrects physical deformities, repairs bone and tissue after injuries, or performs preventive surgeries on patients. Although a large number perform general surgery, many surgeons choose to specialize in a specific area. Specialties include orthopedic surgery (the treatment of the musculoskeletal system), neurological surgery (treatment of the brain and nervous system), cardiovascular surgery, and plastic or reconstructive surgery. Like other physicians, surgeons examine patients, perform and interpret diagnostic tests, and counsel patients on preventive healthcare. Some specialist physicians also perform surgery.

Physicians and surgeons may work in a number of other medical and surgical specialties and subspecialties. The following specialists are some of the most common examples:

Allergists (specialists in diagnosing and treating hay fever and other allergies)

Cardiologists (heart specialists)

Dermatologists (skin specialists)

Gastroenterologists (digestive system specialists)

Ophthalmologists (eye specialists)

Pathologists (specialists who study body tissue to see if it is normal or abnormal)

Radiologists (specialists who review and interpret x-ray pictures and deliver radiation treatments for cancer and other illnesses)

Physicians and surgeons held about 691,400 jobs in 2012. Many physicians work in private offices or clinics, often with a small staff of nurses and administrative personnel. Some practice independently or with a small group of other doctors.

Increasingly, physicians are working in group practices, healthcare organizations, or hospitals, where they share a large number of patients with other doctors. The group setting allows them more time off and lets them coordinate care for their patients, but it gives them less independence than solo practitioners have.

Surgeons and anesthesiologists usually work in sterile environments while performing surgery and may stand for long periods.

Work Schedules

Most physicians and surgeons work full time. Many physicians and surgeons work long, irregular, and overnight hours. Physicians and surgeons may travel between their offices and hospitals to care for their patients. While on call, a physician may need to address a patient’s concerns over the phone or make an emergency visit to a hospital or nursing home.

Education and Training

Physicians and surgeons have demanding education and training requirements. Almost all physicians complete at least 4 years of undergraduate school, 4 years of medical school, and, depending on their specialty, 3 to 8 years in internship and residency programs.

Education

Most applicants to medical school have at least a bachelor's degree, and many have advanced degrees. Although no specific major is required, all students must complete undergraduate work in biology, chemistry, physics, mathematics, and English. Students also take courses in the humanities and social sciences. Some students volunteer at local hospitals or clinics to gain experience in a healthcare setting.

Medical schools are highly competitive. Most applicants must submit transcripts, scores from the Medical College Admission Test (MCAT), and letters of recommendation. Schools also consider an applicant’s personality, leadership qualities, and participation in extracurricular activities. Most schools require applicants to interview with members of the admissions committee.

A few medical schools offer combined undergraduate and medical school programs that last 6 or 7 years.

Students spend most of the first 2 years of medical school in laboratories and classrooms, taking courses such as anatomy, biochemistry, pharmacology, psychology, medical ethics, and the laws governing medicine. They also gain practical skills, learning to take medical histories, examine patients, and diagnose illnesses.

During their last 2 years, medical students work with patients under the supervision of experienced physicians in hospitals and clinics. Through rotations in internal medicine, family practice, obstetrics and gynecology, pediatrics, psychiatry, and surgery, they gain experience in diagnosing and treating illnesses in a variety of areas.

Important Qualities

Communication skills. Physicians and surgeons need to be excellent communicators. They must be able to communicate effectively with their patients and other healthcare support staff.

Compassion. Physicians and surgeons deal with patients who are sick or injured and may be in extreme pain or distress. Physicians and surgeons must be able to treat patients and their families with compassion and understanding.

Detail oriented. Physicians and surgeons must ensure that patients are receiving appropriate treatment and medications. They must also monitor and record various pieces of information related to patient care.

Dexterity. Physicians and surgeons must be good at working with their hands. They work with very precise and sometimes sharp tools, and mistakes can have serious consequences.

Leadership skills. Physicians who work in their own practice need to be effective leaders. They must be able to manage a staff of other professionals to run their practice.

Organizational skills. Some physicians own their own practice. Strong organizational skills, including good recordkeeping, are critical in both medical and business settings.

Patience. Physicians and surgeons may work for long periods with patients who need special attention. Children and adult patients who fear medical treatment may require more patience.

Physical stamina. Physicians and surgeons should be comfortable performing physical tasks, such as lifting or turning disabled patients. Surgeons may spend a great deal of time bending over patients during surgery.

Problem-solving skills. Physicians and surgeons need to evaluate patients’ symptoms and administer the appropriate treatments. They often need to do this quickly in order to save a patient’s life.

Training

After medical school, almost all graduates enter a residency program in their specialty of interest. A residency usually takes place in a hospital and varies in duration, generally lasting from 3 to 8 years, depending on the specialty.

Licenses, Certifications, and Registrations

All states require physicians and surgeons to be licensed; requirements vary by state. To qualify for a license, candidates must graduate from an accredited medical school, complete residency training in their specialty, and pass written and practical exams.

All physicians and surgeons must pass a standardized national licensure examination. M.D.s take the U.S. Medical Licensing Examination (USMLE). D.O.s take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA). For specific state information about licensing, contact your state’s medical board.

Certification is not required for physicians and surgeons; however, it may increase their employment opportunities. M.D.s and D.O.s seeking board certification in a specialty may spend up to 7 years in residency training; the length of time varies with the specialty. An examination after residency is required for certification by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA).

Pay

Wages for physicians and surgeons are among the highest of all occupations. According to the Medical Group Management Association’s Physician Compensation and Production Survey, median total compensation for physicians varies with their type of practice. In 2012, physicians practicing primary care received total median annual compensation of $220,942 and physicians practicing in medical specialties received total median annual compensation of $396,233.

Median annual compensation for selected specialties in 2012, as reported by the Medical Group Management Association, was as follows:

Anesthesiology

$431,977

General surgery

367,885

Obstetrics/gynecology

301,737

Internal medicine

224,110

Psychiatry

220,252

Pediatrics/adolecent medicine

216,069

Family practice (without obstetrics)

207,117

Earnings vary with the physician’s or surgeon’s number of years in practice, geographic region of practice, hours worked, skill, personality, and professional reputation.

Many physicians and surgeons work long, irregular, and overnight hours. Physicians and surgeons may travel between their offices and hospitals to care for their patients. While on call, a physician may need to address a patient’s concerns over the phone or make an emergency visit to a hospital or nursing home.

Job Outlook

Employment of physicians and surgeons is projected to grow 18 percent from 2012 to 2022, faster than the average for all occupations. Job growth will occur because of the continued expansion of healthcare-related industries. The growing and aging population is expected to drive overall growth in the demand for physician services as consumers continue to seek high levels of care that uses the latest technologies, diagnostic tests, and therapies. Some medical schools are increasing their enrollments on the basis of a perceived higher demand for physicians.

Although the demand for physicians and surgeons should continue, some factors will likely reduce growth. New technologies will allow physicians to treat more patients in the same amount of time, thereby reducing the number of physicians who would be needed to complete the same tasks. Physician assistants and nurse practitioners can do many of the routine duties of physicians and may be used to reduce costs at hospitals and outpatient care facilities.

Demand for physicians’ services is sensitive to changes in healthcare reimbursement policies. Consumers may demand fewer physician services if changes to health coverage result in higher out-of-pocket costs for them. However, federal health legislation will expand the number of patients who have access to health insurance, increasing patient access to medical care. Such access will in turn increase demand for the services of physicians and surgeons.

Job Prospects

Job prospects should be good for physicians who are willing to practice in rural and low-income areas, because these areas tend to have difficulty attracting physicians. Job prospects also should be good for physicians in specialties dealing with health issues that largely affect aging baby boomers. For example, physicians specializing in cardiology and radiology will be needed because the risks for heart disease and cancer increase as people age.